Population Screening for Urine Antigens to Detect Asymptomatic Subarachnoid Neurocysticercosis: A Pilot Study in Northern Peru

Subarachnoid neurocysticercosis (SANCC) is a severe and progressive brain infection with Taenia solium. We performed a pilot study of noninvasive screening for SANCC in two endemic villages in northern Peru using a urine antigen screen followed by brain magnetic resonance imaging for participants with elevated levels of antigen. Among the 978 participants screened, we identified eight individuals with SANCC, many of whom were asymptomatic. This represents a minimum prevalence of 0.8% of SANCC, a level higher than expected based on prior studies, and a positive predictive value of 62% for our novel urine screening test. Future studies should confirm whether early detection and management improve clinical outcomes.

Long-term Taenia saginata infection successfully treated with meglumine/diatrizoate sodium

A 46-year-old Japanese man visited our hospital for chronic abdominal pain, persistent diarrhea and discharge of proglottids for 7 years. He had been living in Lao People's Democratic Republic. Ileography using meglumine/diatrizoate sodium (Gastrografin) revealed a long tapeworm. A Taenia saginata including the scolex was excreted through the intestinal tract by the administration of total 780 ml of Gastrografin. Taeniasis is an important disease in the differential diagnosis of imported diseases in Japan. Parasite infection should be suspected in patients with chronic abdominal pain or persistent diarrhea regardless of the findings for small bowel obstruction when there is a history of overseas travel.

Taenia coenurus in the orbit of a chinchilla

A 4-year old, male intact, captive-bred chinchilla (Chinchilla lanigera) was presented due to progressive exophthalmos of the right eye over a 5-month period. Ophthalmic examination revealed exophthalmos with dorsal displacement of the right globe. Retropulsion was decreased and a fluctuant, subcutaneous mass could be palpated posterior and dorsal to the central aspect of the zygomatic bone. Transdermal ultrasonography revealed a fluid-filled mass consistent with a cyst located within the ventral right orbit. Computed tomography demonstrated dorsal displacement of the globe, lateral displacement of the zygomatic arch, and numerous mineral-dense foci within the lumen of the cyst. The cyst was removed en bloc by ventral transpalpebral orbitotomy. Histopathology revealed a single capsulated cyst with multiple invaginated protoscolices, characterized by a prominent scolex with refractile hooklets, suckers, and abundant calcareous corpuscles consistent with a Taenia coenurus. Exophthalmos resolved with surgical therapy and there was no evidence of recurrence or postoperative complications over a period of 2 years. To the authors' knowledge, this is the first reported case of an orbital cyst of parasitic origin in a chinchilla.

Ultrasonographic appearance of colon taeniasis

We present the case of a 50-year-old woman with abdominal pain, nausea, loss of appetite, and frequent stools in whom the routine ultrasonographic examination demonstrated a double-reflective, ribbon-like structure in the lumen of the initial segment of the ascending colon, which suggested colon taeniasis. Because the initial parasitologic analysis yielded negative results and application of albendazol did not have any therapeutic effect, the diagnosis was confirmed by barium enema and subsequently by parasitologic examination of proglottids passed in the stool after application of niclosamide. The double-reflective, ribbon-like structure in the lumen of the intestine seems to be specific to the ultrasonographic appearance of intestinal taeniasis. Transcutaneous ultrasonography of the gastrointestinal tract, performed as a screening method before conventional radiologic or endoscopic examination, can point to the ultimate diagnosis of colon taeniasis.

Successful treatment of Diphyllobothrium latum and Taenia saginata infection by intraduodenal 'Gastrografin' injection

Tapeworm infections are very difficult to cure completely. Thirteen patients with tapeworm infection, seven with Diphyllobothrium latum and six with Taenia saginata, were treated by the introduction of a radio-opaque contrast medium, 'Gastrografin', into the duodenum through a duodenal tube. The whole tapeworm with the scolex was expelled unfragmented within 1 h in eleven cases. One patient expelled a tapeworm 3 days after treatment; the peristalsis of his intestine had been severely disturbed after an attack of cerebral apoplexy. The tapeworm could not be expelled by the remaining patient, probably because she had severe intestinal adhesion. The injection of gastrografin allowed clear visualisation of the tapeworm, the diagnosis of the infection could be confirmed, and the descent of the tapeworm could be observed serially. This treatment had no serious adverse effects in any of out patients.

Method for ejecting cestodes: duodenal tube injection of gastrografin

Most of the conventional anthelmintics for cestodiasis are known to destroy the worm body. The risk of cysticercosis and recurrence of cestodiasis will be avoided only if tapeworms are ejected with intact bodies and scoleces . Two cases with Diphyllobothrium latum and two with Taenia saginata were treated by administration of 200-300 ml of Gastrografin through a duodenal tube. The worm bodies were confirmed by fluoroscopy, and the expelled worms were alive and had intact scoleces . No adverse effects were noted in the patients during or after the treatment.

Radiology of cysticercosis of the central nervous system including computed tomography

Cysticercosis is a parasitic disease in which man serves as the intermediate host of Taenia solium, the pork tapeworm. The larvae have a predilection for the central nervous system and can cause a variety of neurologic and psychiatric symptoms. Areas of involvement are classified as intraventricular, parenchymal, arachnoidal, and mixed. The diagnosis is made primarily by roentgenographic and spinal fluid examinations. The authors reviewed 232 cases of cysticercosis involving the central nervous system. It was found that computed tomography is a useful tool in assessing this illness.

The radiological diagnosis of tapeworms: two cases of Taenia saginata infestation

Images